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Stroke:特发性烟雾现象的成人基础血流动力学障碍与未来卒中风险如何?

2017-03-13 xing.T MedSci原创

由此可见,新发或复发性卒中的风险低于预期。低事件发生率、增加的OEF低患病率和血管重建手术导致的潜在选择偏倚限制了关于增加的OEF与未来卒中风险之间相关性论证性很强的结论。

近日,卒中领域权威杂志Stroke上发表了一篇荟萃分析文章,研究人员旨在检验一个假设,该假设为增加的氧摄取分数(OEF)-通过正电子发射计算机断层扫描测量的一个严重血流动力学障碍标志,是在缺血性卒中发生的独立危险因素。

在2005年和2012年之间研究人员招募了特发性烟雾现象的成年患者进行了一项前瞻性、多中心、盲法评价的纵向队列研究。在参与者招募时测量OEF指标。研究人员对参与者每隔6个月随访一次,得到同侧缺血性脑卒中的发生情况。患者在手术血运重建或随访结束时进行了审查。主要分析是闭塞性血管病变范围内缺血性中风的发生时间。

该研究中有49例患者随访时间中位数为3.7年。OEF增加的16名患者在招募时发生缺血性卒中,另有1名患者发生了脑实质出血。OEF正常的33例患者中有3例患者发生缺血性脑卒中。在每一个大脑半球的基础上,79个烟雾血管病变大脑半球中的21一个半球的基础OEF增加。在OEF增加的大脑半球(n=21)中没有发生缺血性卒中,只有一例出血事件发生。16例(20个大脑半球)患者,其中5例患者在招募时OEF增加,在招募进行血管重建手术之后平均为5.3个月时被审查。

由此可见,新发或复发性卒中的风险低于预期。低事件发生率、增加的OEF低患病率和血管重建手术导致的潜在选择偏倚限制了关于增加的OEF与未来卒中风险之间相关性论证性很强的结论。           

原始出处:

Colin P. Derdeyn, et al. Baseline Hemodynamic Impairment and Future Stroke Risk in Adult Idiopathic Moyamoya Phenomenon Results of a Prospective Natural History Study.Stroke. 2017. https://doi.org/10.1161/STROKEAHA.116.014538

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